Book Review/Commentary: Laboring On (Rothman, Simonds, and Norman, 2007)
Barbara Katz Rothman is a major name among scholars who study birth; she approaches motherhood and birth from a feminist sociological position, and her 1982 book In Labor: Women and Power in the Birthplace is a classic in the field. She’s also written, both movingly and convincingly, about the complicated issues—ethical, feminist, and political in nature—that arise from new technologies, including prenatal tests such as amnios (The Tentative Pregnancy, 1986) and artificial inseminations, especially with surrogates (Recreating Motherhood: Ideology and Technology in a Patriarchal Society, 1989). Her newest work, Laboring On, is an updated version of In Labor, with new interviews with caregivers and a greater focus on doulas. Laboring On is fascinating reading for anyone interested in birth, whether from a medical, midwifery, feminist, or personal perspective.
One of Rothman’s points in the book is that birth choices should not be seen as a rigid home vs. hospital, female care provider vs. male care provider, or even midwife vs. nurse/doctor distinction; the two models of care she discusses (the midwifery model and the medical/obstetric model) are not as easily pegged to simple categories as one may think. For example, Rothman and her co-authors cite interviews with some RNs and the very occasional OB who align themselves more on the side of the midwifery model, whereas they also note that some CNMs approach birth in ways more typical of the medical/obstetric model.
For Rothman, the midwifery approach to pregnancy, childbirth, and mothering is the only model that truly empowers women. She is very plain about her own personal slant on this subject, and indeed she writes in the preface about her own experiences with childbirth:
I came to the decision to have a home birth from feminism. . . which made us all critical of the ways that major institutions of our society treated women, and in particular of the way that medicine as a profession treated the bodies of women. . . . Mine was, I guess I’d say now, . . . a highly politicized birth because, as much as anything else that was happening that day, I was making a point, proving something. I, who had never so much as seen a baby born, was showing the doctor and the world that birth did not have to be a medical event. . . .I just knew that the way birth was managed in standard hospitals was not “feminist” enough for me; it did not put the woman enough in charge, and looked awful besides. (xii)
Even from her first birth, before she had begun her study of midwives, nurses, and other caregivers, Rothman’s focus was clear. Her research over the past thirty-plus years has confirmed her in this regard:
Birth is, I learned and I can say with clarity now, about women. That’s what the midwives taught me, and that’s what my own experiences have shown me. Birth is not about babies. Babies get born. But women give birth. Giving birth is awesome. Babies are miracles, and cute besides, but birth is an Event. It is Something. It is a life-shaking, developmental moment that makes you who you are, that teaches you who you are. (xvii)
According to Rothman, women themselves play a passive role in pregnancy and birth when seen through the medical model, but the midwifery model returns power and agency to woman: “In the midwifery model, the [pregnant] woman herself holds the responsibility for her pregnancy and makes her own decisions. The midwife sees herself as a teacher and a guide for the pregnant woman and her family” (54). Rothman makes this point even clearer here, citing Ina May:
Midwifery, as many midwives conceive of it, can be revolutionary feminist practice. As Ina May Gaskin put it: “You know I’ve always been convinced that as a society we’re doing it all wrong and that we need to utterly change it” (cited in Schlinger 1992: 19). In spreading the word about their worldview, that’s what midwives hope for. (138)
So, why should we care about midwives? Rothman would argue that we need no further reason beyond simply caring about women.